Risk factors for allogenic transfusion after posterior correction surgery for adolescent idiopathic scoliosis

Abstract

Objective To investigate the incidence and risk factors for allogenic transfusion after posterior correction surgery for adolescent idiopathic scoliosis (AIS). Methods We retrospectively analyzed 936 patients (147 male and 789 female) undergoing posterior correction surgery for AIS. The patients, aged (14.4±1.7) (11-18) years, were divided into two groups: postoperative blood transfusion group (n=188) and postoperative non-transfusion group(n=748). The preoperative blood assay and physical examination were performed, and information about the surgery and treatment was collected. Potential risk factors for postoperative allogenic transfusion were evaluated by univariate and multivariate regression analysis. Results Postoperative allogenic transfusion was performed in 188 (20.1%) patients undergoing posterior correction surgery for AIS. Univariate analysis showed that Hb levels, Cobb angle and BMI before operation, estimated blood loss during operation, operation time, tranexamic acid (TXA), number of fused levels, postoperative drainage volume, ASA score, and gender had significant effects on postoperative allogenic transfusion. Logistic regression analysis identified male [odds ratio (OR)=2.258, 95%CI 1.266-4.028], the number of fused levels>12(OR=1.587, 95%CI 1.070-2.353), preoperative hemoglobin lower than 128 g/L(OR=1.956, 95%CI 1.356-2.820), postoperative drainage volume>515 ml(OR=2.025, 95%CI 1.409-2.911), are influencing factors for postoperative allogenic transfusion, the use of TXA (OR=0.497, 95%Cl 0.266-0.930) is the protective fator for it. Conclusions The allogenic transfusion rate after posterior correction surgery for AIS was 20.1% in this study. Male, the numbers of fused levels>12, postoperative drainage volume>515 ml, preoperative Hb<128 g/L are risk factors for postoperative allogenic transfusion, the use of TXA is the only protective fctor for postoperative allogenic transfusion. Key words: Idiopathic scoliosis; Adolescent; Posterior correction surgery; Bloodtransfusion; Risk factors